湘潭地区铜绿假单胞菌的分布及耐药性变迁

Distribution and Drug Resistance Changes of Pseudomonas aeruginosa in Xiangtan Area

目的了解2008-2012年连续五年间湘潭地区铜绿假单胞菌的分布及其对常用抗菌药物的动态变化,为临床控制感染及指导临床合理用药提供依据。方法应用回顾性调查方法,对湖南省湘潭市两家医院临床微生物室2008-2012年各类临床标本分离的铜绿假单胞菌,应用WHONTE5.6分析系统,对其数据进行统计分析。结果铜绿假单胞菌的检出率逐年增加。主要来源于痰液,占76.5%,主要分布在呼吸内科和神经内科分别为27.2%和17.1%。5年间对氨苄西林、头孢唑啉的耐药率大于90%。对复方新诺明、呋喃妥英的耐药率大于80%。结论铜绿假单胞菌对临床常用抗菌药物耐药现象严重,仅对哌拉西林/他唑巴坦、亚胺培南、头孢他啶、庆大霉素、妥布霉素、环丙沙星、左旋氧氟沙星保持相对高的抗菌活性。应加强对耐药菌株的监控,尤其是耐碳青霉烯铜绿假单胞菌的医院内感染,防止其流行扩散。

Objective To investigate the distribution of Pseudomonas aeruginosa and the dynamic changes of commonly used antibiotics in Xiangtan Area from 2008 to 2012 so as to provide a basis for the infection control and rational use of drugs.Methods With the retrospective survey,the data about Pseudomonas aeruginosa isolated from clinical specimens,which were collected from clinical microbiology laboratories of two hospitals in Xiangtan,Hunan Province from 2008 to 2012,were analyzed with WHONTE5.6 analysis system.Results The detection rate of Pseudomonas aeruginosa was increased year by year.It mainly came from sputum （76.5 ％）,and distributed in respiratory department （27.2 ％） and department of neurology （17.1％）.During these 5 years,the resistance rates of Pseudomonas aeruginosa to ampicillin and cefazolin were both more than 90％.And the resistance rates of Pseudomonas aeruginosa to cotrimoxazole and nitrofurantoin were both more than 80％.Conclusions Pseudomonas aeruginosa shows serious drug resistance against commonly used antimicrobial agents in clinical practice.It only has relatively high antibacterial activity for piperacillin/tazobactam,imipenem,ceftazidime,gentamicin,tobramycin,ciprofloxacin and levofloxacin.It is necessary to strengthen the monitoring of drug-resistant strains,especially in nosocomial infections caused by carbapenem-resistant Pseudomonas aeruginosa so as to prevent their spread.